Descemet's Stripping Only
For patients with early- to mid-stage Fuchs’ dystrophy, an alternative to DMEK or DSAEK is for your surgeon to remove a small area of unhealthy central endothelium and Descemet membrane using a technique known as DSO / DWEK. Rather than implanting donor corneal tissue, which generally provides visual recovery in 1 to 3 weeks, you wait for your own endothelial cells to migrate from the intact peripheral area to cover the central area from which the unhealthy cells were removed.
After the cells migrate, they can begin removing fluid from the central cornea to help your vision clear without the use of donor tissue. We have been evaluating a novel growth factor that can be injected into the eye to speed visual recovery after DSO. Dr. Francis Price reported encouraging findings from this study at a recent World Cornea Congress.
Understanding How Fuchs' Develops
We collect corneal tissue from transplant patients to help identify the underlying causes of this leading reason for corneal transplantation. If we can find the cause we will be better positioned to develop treatments to halt the progression of the disease.
New Treatments to Alleviate Painful Dry Eye
Dry Eye is common, affecting 10% of the population, and can be debilitating, particularly after eye surgery. We continue to investigate new, innovative treatments.
Contact-Lens Related Eye Infections
We are conducting a genetic study to find out why certain people are more susceptible to contact lens-related eye infections.
Corneal Strengthening Treatment For Keratoconus
Keratoconus causes thinning and bulging of the cornea and can require a cornea transplant. We participated in studies leading to FDA approval of “crosslinking”, a treatment that strengthens the cornea to prevent keratoconus. During a crosslinking treatment, the cornea is saturated with riboflavin (vitamin B) and then exposed to light to trigger a photochemical reaction that stiffens the cornea. We are conducting a randomized study to determine whether an accelerated 10-minute treatment with a higher intensity light is equivalent to the approved 30-minute treatment with a lower intensity light to ease the patient experience.
Determining correct dosing of anti-rejection medications in DMEK patients
The standard regimen of post-operative medications for cornea transplant recipients include antibiotics and relatively strong steroid eye drops taken to prevent your immune system from rejecting the new donor tissue. Having helped pioneer the DMEK technique and observing that DMEK had such a low risk of rejection, Dr. Price and the Cornea Research Foundation embarked on a series of studies to evaluate corticosteroid eye drop strength and dosing regimens over the last several years.
The goal of the studies were to protect the transplant from immunologic graft rejection while reducing the corticosteroid side effects. This is important because we know through tracking our transplant outcomes that 1 in 3 patients will experience the unfortunate side effect of pressure increases within one year using a standard steroid eye drop regimen. If left untreated, the pressure problems can eventually lead to glaucoma and cause permanent vision loss.
Within the studies, we compared 3 different steroid medications of varying strength. Groups of patients were randomized to receive different steroid eye drops and were followed for one year. We evaluated the health of their transplant as well as any pressure changes within that year. Once patients reached the one year mark, they were given the option to either stay on the drop, switch to a lower dose if they were on the highest dose, or go off the drops entirely. Whichever they chose, we continued to examine the transplant and the eye pressure regularly.
We found that the risk of rejection was very low even when patients switched to a low-strength steroid eye drop at 1 month. So now we reduce steroid strength at 1 to 2 months after DMEK and that substantially reduces the risk of pressure elevation.
A few of those who discontinued steroid eye drops at one year (about 1 out of 17) experienced a rejection episode. In most cases it was mild and could be successfully treated by resuming steroids. Usually, the patient didn’t even realize they were having a rejection episode - our doctors detected it during one of the planned study examinations. Those who chose to continue using a low-strength eye drop did not experience any incidence of graft rejection episodes or pressure increases. Therefore our current recommendation is to stay on the low dose steroid long term.
We continue to monitor the progress of these individuals over the long run. We believe the findings from our anti-rejection medication studies will allow us to reduce the incidence of future glaucoma development in cornea transplant patients, particularly since many new DMEK surgeons are adopting our recommended dosing through the sharing of our results in leading ophthalmology publications.
Eye Drops for Presbyopia
As we age, the lens inside our eye has more difficulty fully adjusting to help us see up close. We participated in the clinical studies that resulted in the first eye drop (Vuity®) approved to treat presbyopia which preserves our ability to see up close and avoid the need for reading glasses.
Corneal Neovascularization
We are conducting 2 studies to evaluate the use of corneal crosslinking in conjunction with antibiotics to treat corneal ulcers caused by bacterial or fungal infections. We are enrolling patients with untreated corneal ulcers into the first study and patients with ulcers that have not responded well to standard treatment into the second study.
Corneal Ulcers
We are conducting 2 studies to evaluate the use of corneal crosslinking in conjunction with antibiotics to treat corneal ulcers caused by bacterial or fungal infections. We are enrolling patients with untreated corneal ulcers into the first study and patients with ulcers that have not responded well to standard treatment into the second study.
Neurotrophic Keratitis
People sometimes lose sensation in the cornea, because of disease, such as herpes virus, or because of trauma, chemical injury, or contact lens abuse. Loss of sensation reduces tear production and blinking. It can ultimately lead to a corneal ulcer or corneal perforation. We are evaluating the use of eye drops that contain a novel human growth factor to help heal the cornea.